32 DISEASES OF THE AIR-PASSAGES. 



piece of bone back into the sinus^ which on one occasion 

 happened to myself, though no harm resulted from its 

 remaining there : to get it out being impossible. The aper- 

 ture made, at first clean tepid water may be syringed into 

 the sinus, which, if the passage be unobstructed, will run out 

 at the corresponding nostril mingled with some of the mat- 

 ters discharged. After this the kreasote injection may be 

 tried, and repeated. After a day or two, not only does the 

 flux from the nose become diminished, but effused masses of 

 coagulated blood sometimes maketheir appearance, which may, 

 in some cases, be extracted with forceps through the aper- 

 ture. At other times, however, nothing of the sort happens, 

 and the injections are persisted in for several days, per- 

 haps weeks, before any remarkable change takes place. In 

 favorable cases the gleet matter degenerates from a muco- 

 purulent flux into aqueous or serous running, and that after a 

 time but occasional, while the enlarged glands gradually 

 subside. Notwithstanding such favorable change, however, 

 which may or may not be the immediate result of our treat- 

 ment, we must always, for the first at least, be in expectation 

 of relapses. One morning the nose may seem all but dry, 

 while the next or a few days after, the running will reappear 

 as violently as ever, and the submaxillary gland will at the 

 same time resume its former magnitude. Sometimes, how- 

 ever,' after the injections have been used for some days, irri- 

 tation will, from them, be set up to that degree to itself cause 

 augmented discharge and glandular tumefaction; under which 

 circumstance it will be necessary to discontinue them, at 

 least for a time. 



One thing it is very needful to be careful about from the 

 first, and that is, that the hole made by the trephine does 

 not speedily become closed up. I say, " speedily,'^ because, 

 ultimately, and before so very long, close up it will in spite 

 of us. The way in which I oppose Nature's efibrts is to 

 fit a wooden plug or a phial cork into the opening. This for 

 a time answers the purpose of counteracting closure, as well 

 as shutting out air and dirt. In one of the two cases 

 I have published, the discharge returning after I had 



